A Novel, Fully Covered Laser-Cut Nitinol Stent with Antimigration Properties for Nonresectable Distal Malignant Biliary Obstruction: A Multicenter Feasibility Study

• Published in: Gut and liver Vol. 7; no. 6; pp. 725 - 730
• Main Authors: Hiroyuki Isayama, Kazumichi Kawakubo, Yousuke Nakai, Kouta Inoue, Chimyon Gon, Saburo Matsubara, Hirofumi Kogure, Yukiko Ito, Takeshi Tsujino, Suguru Mizuno, Tsuyoshi Hamada, Rie Uchino, Koji Miyabayashi, Keisuke Yamamoto, Takashi Sasaki, Natsuyo Yamamoto, Kenji Hirano, Naoki Sasahira, Minoru Tada, Kazuhiko Koike
• Format: Journal Article
• Language: Korean
• Published: 대한소화기내시경학회 30.11.2013
• Subjects: Cholangiography; Cholestasis; Endoscopic retrograde; extrahepatic; Stents
• ISSN: 1976-2283; 2005-1212

Background/Aims: Stent migration occurs frequently, but the prevention of complications resulting from covered self-expandable metal stents (C-SEMSs) remains unresolved. We prospectively assessed a newly developed C-SEMS, a modi-fied covered Zeo stent (m-CZS), in terms of its antimigration effect. Methods: Between February 2010 and January 2011, an m-CZS was inserted into 42 patients (31 initial drainage cases and 11 reintervention cases) at a tertiary referral center and three affiliated hospitals. The laser-cut stent was flared for 1.5 cm at both ends, with a 1 cm raised bank located 1 cm in from each flared end. The main outcome of this study was the rate of stent migration, and second-ary outcomes were the rate of recurrent biliary obstruction (RBO), the time to RBO, the frequencies of complications, and overall survival. Results: Of the 31 patients with initial drainage, stent migration occurred in four (12.9%, 95% con-fidence interval, 5.1% to 29.0%), with a mean time of 131 days. RBO occurred in 18 (58%), with a median time to RBO of 107 days. Following previous C-SEMS migration, seven of 10 patients (70%) did not experience m-CZS migration until death. Conclusions: m-CZSs with antimigration properties ef-fectively, although not completely, prevented stent migration after stent insertion. (Gut Liver 2013;7:725-730)